Radiation Oncology Journal. 2016 ; 34/1 : 64 ~ 75
A feasibility study evaluating the relationship between dose and focal liver reaction in stereotactic ablative radiotherapy for liver cancer based on intensity change of Gd-EOB-DTPA-enhanced magnetic resonance images
ang Hoon Jung, PhD1, Jeong Il Yu, MD1, Hee Chul Park, MD, PhD1,2, Do Hoon Lim, MD, PhD1, Youngyih Han, PhD1 and
Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul; 2Department of Medical Device Management and Research, Samsung Advanced Institute for Health Sciences & Technology, Sungkyunkwan University, Seoul

Purpose: In order to evaluate the relationship between the dose to the liver parenchyma and focal liver reaction (FLR) after stereotactic ablative body radiotherapy (SABR), we suggest a novel method using a three-dimensional dose distribution and change in signal intensity of gadoxetate disodium-gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) hepatobiliary phase images.
Materials and Methods: In our method, change of the signal intensity between the pretreatment and follow-up hepatobiliary phase images of Gd-EOB-DTPA-enhanced MRI was calculated and then threshold dose (TD) for developing FLR was obtained from correlation of dose with the change of the signal intensity. For validation of the method, TDs for six patients, who had been treated for liver cancer with SABR with 45?60 Gy in 3 fractions, were calculated using the method, and we evaluated concordance between volume enclosed by isodose of TD by the method and volume identified as FLR by a physician.
Results: The dose to normal liver was correlated with change in signal intensity between pretreatment and follow-up MRI with a median R2 of 0.935 (range, 0.748 to 0.985). The median TD by the method was 23.5 Gy (range, 18.3 to 39.4 Gy). The median value of concordance was 84.5% (range, 44.7% to 95.9%).
Conclusion: Our method is capable of providing a quantitative evaluation of the relationship between dose and intensity changes on follow-up MRI, as well as determining individual TD for developing FLR. We expect our method to provide better information about the individual relationship between dose and FLR in radiotherapy for liver cancer.
KEY WORD : Keywords: Liver neoplasms, Stereotactic body radiotherapy, Radiation effects, Magnetic resonance imaging, Gadolinium DTPA, Computer assisted image analysis
서울 서대문구 연세로 50-1 연세의료원 광혜관 2층 방사선종양학교실내 (우.03722)
Tel: 02)471-5623   E-mail: kosro@kosro.or.kr
Copyright(c) The Korean Society for Radiation Oncology (KOSRO). ALL